Method and apparatus for varicose vein treatment using acoustic hemostasis

Abstract

A method of treating a perforator vein comprises applying ultrasound to the perforator vein and occluding the perforator vein with the ultrasound. An apparatus for treating blood vessels comprises an ultrasound emitter, wherein the ultrasound emitter is configured to emit ultrasound at multiple therapeutic ultrasound frequencies during a treatment cycle. The apparatus further comprises an acoustic coupler in sonic communication with the emitter, wherein the acoustic coupler has an acoustic coupling surface configured to contact a patient and facilitate delivery of ultrasound to the patient and wherein the acoustic coupler provides a conduction path for ultrasound from the emitter to the acoustic coupling surface. The apparatus further comprises an acoustic coupler containing a displaceable acoustic coupling material. The apparatus further comprises an acoustic coupler configured to vary the length of the conduction path in accordance with variation in the thickness of the acoustic coupling material disposed between the emitter and the acoustic coupling surface.

1 . A method for treating a perforator vein, said method comprising: 
 applying ultrasound to said perforator vein; and    occluding said perforator vein with said ultrasound.    
     
     
         2 . The method of  claim 1 , wherein said ultrasound is high intensity focused ultrasound (HIFU).  
     
     
         3 . The method of  claim 1 , wherein occluding said perforator vein comprises occluding said vein at a location below or near the deep fascia of a leg.  
     
     
         4 . The method of  claim 1 , wherein occluding said perforator vein comprises occluding said vein at a location below the deep fascia of a leg.  
     
     
         5 . The method of  claim 1 , wherein applying ultrasound to said perforator vein comprises generating heat.  
     
     
         6 . The method of  claim 5 , further comprising causing tissue necrosis, vein wall collagen contraction, vein diameter reduction and fibrotic occlusion, via said generated heat.  
     
     
         7 . The method of  claim 1 , wherein applying ultrasound to said perforator vein comprises disrupting the endothelium of said vein with said ultrasound.  
     
     
         8 . The method of  claim 1 , further comprising applying subfascial, perifascial or subcutaneous tumescent fluid near said perforator vein.  
     
     
         9 . The method of  claim 8 , further comprising causing compression of the inner walls of said perforator vein toward each other with said tumescent fluid.  
     
     
         10 . The method of  claim 8 , wherein applying ultrasound to said perforator vein comprises propagating said ultrasound through said tumescent fluid.  
     
     
         11 . The method of  claim 1 , wherein applying ultrasound to said perforator vein comprises initiating cavitation in or near said perforator vein.  
     
     
         12 . The method of  claim 11 , further comprising limiting the depth of ultrasound beam penetration with the cavitation.  
     
     
         13 . The method of  claim 1 , wherein applying ultrasound comprises applying ultrasound at multiple frequencies.  
     
     
         14 . The method of  claim 1 , wherein said ultrasound is applied via an ultrasound probe.  
     
     
         15 . The method of  claim 14 , further comprising displacing said ultrasound probe along the direction of propagation of said ultrasound while applying said ultrasound.  
     
     
         16 . The method of  claim 14 , further comprising manually compressing tissue near said perforator vein with said ultrasound probe.  
     
     
         17 . The method of  claim 16 , wherein manually compressing comprises adjusting the location of a focal point of said ultrasound.  
     
     
         18 . The method of  claim 1 , wherein applying ultrasound comprises applying low-power ultrasound during a low-power application phase and high-power ultrasound during a high-power application phase.  
     
     
         19 . A method of facilitating perforator vein treatment with an ultrasound-generating vein treatment apparatus, said method comprising: 
 configuring said vein treatment apparatus to apply ultrasound to one or more perforator veins; and    configuring said vein treatment apparatus to occlude said one or more perforator veins with said ultrasound.    
     
     
         20 . The method of  claim 19 , further comprising configuring said ultrasound-generating vein treatment apparatus to function in both a diagnostic and therapeutic mode.  
     
     
         21 . The method of  claim 19 , further comprising equipping said ultrasound-generating vein treatment apparatus with a standoff to deliver said ultrasound.  
     
     
         22 . The method of  claim 21 , further comprising equipping said ultrasound-generating vein treatment apparatus with a flow path in communication with said standoff to facilitate adjusting a standoff distance via material flow to or from said standoff.  
     
     
         23 . A method of treating a vein, said method comprising: 
 applying tumescent fluid to tissue near said vein;    applying ultrasound to said vein; and    occluding said vein with said ultrasound.    
     
     
         24 . The method of  claim 23 , wherein said ultrasound is high intensity focused ultrasound.  
     
     
         25 . The method of  claim 23 , wherein occluding said vein comprises occluding said vein at a location below or near the deep fascia of a leg.  
     
     
         26 . The method of  claim 23 , wherein occluding said vein comprises occluding said vein at a location below the deep fascia of a leg.  
     
     
         27 . The method of  claim 23 , wherein applying ultrasound to said vein comprises disrupting the endothelium of said vein with said ultrasound.  
     
     
         28 . The method of  claim 23 , wherein applying ultrasound to said vein comprises generating heat.  
     
     
         29 . The method of  claim 28 , further comprising causing tissue necrosis, vein wall collagen contraction, vein diameter reduction and fibrotic occlusion, via said generated heat.  
     
     
         30 . The method of  claim 23 , wherein applying said tumescent fluid further comprises applying subfascial, perifascial or subcutaneous tumescent fluid near said vein.  
     
     
         31 . The method of  claim 23 , further comprising causing compression of the inner walls of said vein toward each other with said tumescent fluid.  
     
     
         32 . The method of  claim 23 , wherein applying ultrasound to said vein comprises propagating said ultrasound through said tumescent fluid.  
     
     
         33 . The method of  claim 23 , wherein applying ultrasound to said vein comprises initiating cavitation in or near said vein.  
     
     
         34 . The method of  claim 33 , further comprising limiting the depth of ultrasound beam penetration with the cavitation.  
     
     
         35 . The method of  claim 23 , wherein applying ultrasound comprises applying ultrasound at multiple frequencies.  
     
     
         36 . The method of  claim 23 , wherein said vein is a perforator vein.  
     
     
         37 . The method of  claim 23 , wherein applying ultrasound comprises applying low-power ultrasound during a low-power application phase and high-power ultrasound during a high-power application phase.  
     
     
         38 . An apparatus for treating blood vessels, said apparatus comprising: 
 an ultrasound emitter, said ultrasound emitter being configured to emit ultrasound at multiple therapeutic ultrasound frequencies during a treatment cycle; and    an acoustic coupler in sonic communication with said emitter, said acoustic coupler having an acoustic coupling surface configured to contact a patient and facilitate delivery of ultrasound to said patient, said acoustic coupler providing a conduction path for ultrasound from said emitter to said acoustic coupling surface;    said acoustic coupler containing a displaceable acoustic coupling material;    said acoustic coupler being configured to vary the length of said conduction path in accordance with variation in the thickness of the acoustic coupling material disposed between said emitter and said acoustic coupling surface.    
     
     
         39 . The apparatus of  claim 38 , wherein said acoustic coupling material is flowable and said acoustic coupler comprises a flow path configured to allow said acoustic coupling material to flow in or out of said acoustic coupler, to facilitate varying the length of said conduction path.  
     
     
         40 . The apparatus of  claim 39 , wherein said flow path extends from said acoustic coupler to a coupling material reservoir.  
     
     
         41 . The apparatus of  claim 38 , wherein said acoustic coupler comprises a compartment containing a fluid or mixture of fluid.  
     
     
         42 . The apparatus of  claim 38 , wherein said acoustic coupling material comprises a gel.  
     
     
         43 . The apparatus of  claim 38 , wherein said acoustic coupling material comprises a degassed liquid.  
     
     
         44 . The apparatus of  claim 38 , wherein said acoustic coupler is a lens.  
     
     
         45 . The apparatus of  claim 38 , wherein said acoustic coupler comprises a standoff.  
     
     
         46 . A method of treating a vein, said method comprising: 
 emitting multiple ultrasound frequencies with an ultrasound probe;    applying said multiple ultrasound frequencies to a treatment region that includes a portion of said vein;    adjusting the distance between said ultrasound probe and said treatment region while applying said multiple ultrasound frequencies; and    occluding said vein with said multiple ultrasound frequencies.    
     
     
         47 . The method of  claim 46 , wherein emitting multiple ultrasound frequencies comprises creating a pattern of multiple focal areas in said treatment region; and 
 adjusting said distance comprises moving said pattern of focal areas within said treatment region.    
     
     
         48 . The method of  claim 47 , wherein moving said pattern of focal areas comprises moving said pattern along a direction of propagation of said ultrasound.  
     
     
         49 . The method of  claim 46 , wherein said vein is a perforator vein.  
     
     
         50 . The method of  claim 46 , further comprising applying subfascial, perifascial or subcutaneous tumescent fluid near said vein.  
     
     
         51 . A method comprising: 
 emitting a first ultrasound frequency with an ultrasound probe;    applying said first ultrasound frequency to a first target region near a vein;    adjusting the distance between said ultrasound probe and said first target region while applying said first ultrasound frequency;    after applying said first ultrasound frequency, emitting a second ultrasound frequency with said ultrasound probe;    applying said second ultrasound frequency to a second target region near said vein; and    adjusting the distance between said ultrasound probe and said treatment region while applying said second ultrasound frequency.    
     
     
         52 . The method of  claim 51 , further comprising selecting one of said first frequency and said second frequency for further application of ultrasound to said vein at said selected frequency.  
     
     
         53 . The method of  claim 52 , further comprising applying ultrasound at said selected frequency to said vein at a power level sufficient to occlude said vein.  
     
     
         54 . The method of  claim 52 , further comprising observing a focal point or area of said applied first and second ultrasound frequencies; wherein said selecting comprises selecting based on said observing.  
     
     
         55 . The method of  claim 51 , wherein said second target region at least overlaps said first target region.  
     
     
         56 . The method of  claim 51 , wherein adjusting the distance between said ultrasound probe and said first target region comprises moving a focal point or area of said applied first ultrasound relative to said first target region.  
     
     
         57 . A method comprising: 
 emitting low-power ultrasound with an ultrasound probe;    applying said low-power ultrasound to a target region near a vein;    adjusting the distance between said ultrasound probe and said target region while applying said low-power ultrasound;    after applying said low-power ultrasound, applying high-power ultrasound to said target region to occlude said vein.    
     
     
         58 . The method of  claim 57 , wherein adjusting the distance comprises placing a focal point or region of said low-power ultrasound at a desired treatment location.  
     
     
         59 . The method of  claim 58 , further comprising applying said high-power ultrasound to said desired treatment location.  
     
     
         60 . The method of  claim 57 , further comprising observing a focal point or region of said low-power ultrasound, and aiming said high-power ultrasound with based on the location of said focal point or region.  
     
     
         61 . The method of  claim 57 , wherein said vein comprises a perforator vein.